TABLE 1—
Estimated Effects of Individual Interventions Over 5 Years: United States, 2016–2020
| Intervention | Mean Changea Compared With the Status Quo | ||||
| Discounted Net Present LYs,b No. in Thousands (%) | Discounted Net Present QALYs,b No. in Thousands (%) | Pill Deaths, No. (%) | Heroin Deaths, No. (%) | Total Opioid Deaths, No. (%) | |
| Acute pain prescribing | 240 (0.004) | −770 (−0.013) | −2 000 (−2.3) | 100 (0.0) | −1 900 (−0.8) |
| Prescribing for transitioning pain | 30 (0.001) | 90 (0.002) | −800 (−1.0) | 700 (0.4) | −200 (−0.1) |
| Chronic pain prescribing | −90 (−0.002) | 320 (0.005) | −8 300 (−9.7) | 10 600 (6.9) | 2 300 (1.0) |
| Drug rescheduling | −1 330 (−0.021) | 110 (0.002) | −45 500 (−53.3) | 70 000 (45.6) | 24 500 (10.3) |
| PMP | −1 260 (−0.020) | −880 (–0.014) | −19 100 (−22.4) | 34 400 (22.4) | 15 300 (6.4) |
| Drug reformulation | 150 (0.002) | 1 060 (0.017) | −15 600 (−18.3) | 16 900 (11.0) | 1 300 (0.5) |
| Excess opioid disposal | 80 (0.001) | 270 (0.004) | −2 800 (−3.3) | 2 500 (1.7) | −300 (−0.1) |
| Naloxone availability | 640 (0.010) | 530 (0.009) | −4 200 (−4.9) | −6 000 (−3.9) | −10 200 (-4.3) |
| Needle exchange | 160 (0.003) | 130 (0.002) | 0 (0.0) | −2 700 (−1.8) | −2 700 (−1.1) |
| MAT | 390 (0.006) | 670 (0.011) | −900 (−1.1) | −4 000 (−2.6) | −4 900 (−2.1) |
| Psychosocial treatment | 220 (0.004) | 340 (0.005) | −600 (−0.7) | −1 300 (−0.9) | −1 900 (−0.8) |
Note. LY = life year; MAT = medication-assisted treatment; PMP = prescription monitoring program; QALY = quality-adjusted life year.
a
Ranges over the 10 base cases are shown Table F (available as a supplement to the online version of this article at http://www.ajph.org).
b
Discounted to 2016.